{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T04:13:07Z","timestamp":1747714387180,"version":"3.40.5"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Eine 20-j\u00e4hrige Patientin wurde via Rettungsdienst mit Vigilanz-Minderung und Schock in die Notaufnahme eingeliefert. Bislang waren au\u00dfer \u00dcbergewicht keine relevanten Vorerkrankungen bekannt.<\/jats:p><jats:p>Die Patientin demonstrierte sich hypotensiv, tachykard, hypertherm und somnolent mit br\u00e4unlichem Hautkolorit. Computertomografisch stellte sich ein diffuses Hirn\u00f6dem dar. Laborchemisch fielen Infektzeichen, eine Hyponatri\u00e4mie, ein Nierenversagen, eine kombinierte metabolische Azidose mit erheblicher Keton\u00e4mie und geringf\u00fcgiger Laktat\u00e4mie, eine prim\u00e4re Hypothyreose und eine Nebennierenrinden-Insuffizienz auf. Ein Anhaltspunkt f\u00fcr einen Diabetes mellitus ergab sich nicht. Die Infektquelle konnte nicht ausgemacht werden.<\/jats:p><jats:p>Akute Addison-Krise bei Sepsis als Erstmanifestation eines autoimmunbedingten pluriglandul\u00e4ren Syndroms (APS) Typ 2.<\/jats:p><jats:p>Unter Therapie, zun\u00e4chst mit Hydrokortison und Breitband-Antibiotika, supportiven Ma\u00dfnahmen sowie L-Thyroxin im Verlauf konnte die Situation innerhalb weniger Tage stabilisiert werden.<\/jats:p><jats:p>Die Kombination aus Hunger-Stoffwechsel und endokrinen Erkrankungen kann auch in Abwesenheit eines Diabetes mellitus zu einer Ketoazidose f\u00fchren. Differenzialdiagnostisch sollte insbesondere eine Nebennierenrinden-Insuffizienz erwogen werden.<\/jats:p>","DOI":"10.1055\/a-2540-9824","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T23:08:26Z","timestamp":1747696106000},"page":"713-719","source":"Crossref","is-referenced-by-count":0,"title":["Hypoglyk\u00e4me Ketoazidose \u2013 ein endokriner Notfall"],"prefix":"10.1055","volume":"150","author":[{"given":"Christina","family":"Sieger","sequence":"additional","affiliation":[{"name":"Sektion Diabetologie, Endokrinologie und Stoffwechsel, Universit\u00e4tsklinik St. Josef-Hospital, Katholisches Klinikum Bochum, Universit\u00e4tsklinikum der Ruhr-Universit\u00e4t Bochum,"},{"name":"Diabeteszentrum Bochum\/Hattingen, Klinik Blankenstein, Ruhr-Universit\u00e4t Bochum,"},{"name":"Zentrum f\u00fcr Seltene Endokrine Erkrankungen (ZSEK), Centrum f\u00fcr Seltene Erkrankungen Ruhr (CeSER), Ruhr-Universit\u00e4t Bochum, Bochum"},{"name":"Zentrum f\u00fcr Diabetestechnologie, Klinik Blankenstein, Ruhr-Universit\u00e4t Bochum, Bochum"},{"name":"Zentrum f\u00fcr Schilddr\u00fcsenmedizin, Universit\u00e4tsklinik St. Josef-Hospital, Ruhr-Universit\u00e4t Bochum, Bochum"},{"name":"Medicover Bochum (MVZ), Praxis f\u00fcr Innere Medizin, Endokrinologie, Rheumatologie, Kinderendokrinologie und Gyn\u00e4kologie, Bochum, Bochum"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1185-3549","authenticated-orcid":false,"given":"Johannes Wolfgang","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Sektion Diabetologie, Endokrinologie und Stoffwechsel, Universit\u00e4tsklinik St. Josef-Hospital, Katholisches Klinikum Bochum, Universit\u00e4tsklinikum der Ruhr-Universit\u00e4t Bochum,"},{"name":"Diabeteszentrum Bochum\/ Hattingen, Klinik Blankenstein, Ruhr-Universit\u00e4t Bochum,"},{"name":"Zentrum f\u00fcr Seltene Endokrine Erkrankungen (ZSEK), Centrum f\u00fcr Seltene Erkrankungen Ruhr (CeSER), Ruhr-Universit\u00e4t Bochum, bochum"},{"name":"Zentrum f\u00fcr Diabetestechnologie, Klinik Blankenstein, Ruhr-Universit\u00e4t Bochum, bochum"},{"name":"Zentrum f\u00fcr Schilddr\u00fcsenmedizin, Universit\u00e4tsklinik St. Josef-Hospital, Ruhr-Universit\u00e4t Bochum, bochum"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15466","article-title":"Severe hypoglycaemia and diabetic ketoacidosis in adults presenting to a hospital emergency department: Adverse prognostic markers for survival in type 2 diabetes and the role of SGLT2 inhibitors","author":"SH Song","year":"2024","journal-title":"Diabet Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1055\/a-2130-1938","article-title":"Adrenal Crisis \u2013 Definition, Prevention and Treatment: Results from a Delphi Survey","volume":"56","author":"T Kienitz","year":"2024","journal-title":"Horm Metab Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"R115","DOI":"10.1530\/EJE-14-0824","article-title":"Extensive expertise in endocrinology. 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